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  <BODY style="font-family: Arial">
    <FORM method="POST" action="pm:C:\ocerd\ORDERRECEIPT.HTML" onSubmit="return Verify(this)">
      <CENTER>
        <TABLE border="0" cellpadding="1">
          <TR>
            <TD bgcolor="#FFFFFF">

              <TABLE border="0" cellpadding="10">

                <TR>
                  <TD bgcolor="#ffffcc" align="center" width="500" valign="middle">
                    <TABLE border="0" cols="2" style="font-size: 9pt; color: black; font-family: verdana, helvetica" width="100%" cellspacing="2" cellpadding="0">


                      <TR id="COMPANY_TR">
                        <TD valign="top" bgcolor="#ffffcc" align="right">
                          <DIV id="COMPANY" style="font-weight:bold">
                            <NOBR>Company</NOBR>
                          </DIV>
                        </TD>
                        <TD>&nbsp;&nbsp;&nbsp;</TD>
                        <TD valign="top">
                          <INPUT type="text" name="COMPANY_VAL" id="COMPANY_VAL" size="30" maxlength="40" value="" >
                        </TD>
                      </TR>


                      <TR id="CONTACT_TR">
                        <TD valign="top" bgcolor="#ffffcc" align="right">
                          <DIV id="CONTACT" style="font-weight:bold">
                            <NOBR>Contact</NOBR>
                          </DIV>
                        </TD>
                        <TD>&nbsp;&nbsp;&nbsp;</TD>
                        <TD valign="top">
                          <INPUT type="text" name="CONTACT_VAL" id="CONTACT_VAL" size="30" maxlength="40" value="" >
                        </TD>
                      </TR>


                      <TR id="EMAIL_ADD_TR">
                        <TD valign="top" bgcolor="#ffffcc" align="right">
                          <DIV id="EMAIL_ADD" style="font-weight:normal">
                            <NOBR>E-Mail Address</NOBR>
                          </DIV>
                        </TD>
                        <TD>&nbsp;&nbsp;&nbsp;</TD>
                        <TD valign="top">
                          <INPUT type="text" name="EMAIL_ADD_VAL" id="EMAIL_ADD_VAL" size="30" maxlength="79" value="" >
                        </TD>
                      </TR>


                      <TR id="PHN_NUM1_TR">
                        <TD valign="top" bgcolor="#ffffcc" align="right">
                          <DIV id="PHN_NUM1" style="font-weight:normal">
                            <NOBR>Phone Number</NOBR>
                          </DIV>
                        </TD>
                        <TD>&nbsp;&nbsp;&nbsp;</TD>
                        <TD valign="top">
                          <INPUT type="text" name="PHN_NUM1_VAL" id="PHN_NUM1_VAL" size="30" maxlength="79" value="" >
                        </TD>
                      </TR>


                      <TR id="PHN_NUM2_TR">
                        <TD valign="top" bgcolor="#ffffcc" align="right">
                          <DIV id="PHN_NUM2" style="font-weight:normal">
                            <NOBR>Phone Number 2</NOBR>
                          </DIV>
                        </TD>
                        <TD>&nbsp;&nbsp;&nbsp;</TD>
                        <TD valign="top">
                          <INPUT type="text" name="PHN_NUM2_VAL" id="PHN_NUM2_VAL" size="30" maxlength="79" value="" >
                        </TD>
                      </TR>


                      <TR id="FAX_NUM_TR">
                        <TD valign="top" bgcolor="#ffffcc" align="right">
                          <DIV id="FAX_NUM" style="font-weight:normal">
                            <NOBR>Fax Number</NOBR>
                          </DIV>
                        </TD>
                        <TD>&nbsp;&nbsp;&nbsp;</TD>
                        <TD valign="top">
                          <INPUT type="text" name="FAX_NUM_VAL" id="FAX_NUM_VAL" size="30" maxlength="79" value="" >
                        </TD>
                      </TR>


                      <TR id="ACCT_NUM_TR">
                        <TD valign="top" bgcolor="#ffffcc" align="right">
                          <DIV id="ACCT_NUM" style="font-weight:normal">
                            <NOBR>Account Number</NOBR>
                          </DIV>
                        </TD>
                        <TD>&nbsp;&nbsp;&nbsp;</TD>
                        <TD valign="top">
                          <INPUT type="text" name="ACCT_NUM_VAL" id="ACCT_NUM_VAL" size="30" maxlength="40" value="" >
                        </TD>
                      </TR>


                      <TR id="ADD_CON_INFO_TR">
                        <TD valign="top" bgcolor="#ffffcc" align="right">
                          <DIV id="ADD_CON_INFO" style="font-weight:normal">
                            <NOBR>Contact Information</NOBR>
                          </DIV>
                        </TD>
                        <TD>&nbsp;&nbsp;&nbsp;</TD>
                        <TD valign="top">
                          <TEXTAREA rows="2" id="ADD_CON_INFO_VAL" name="ADD_CON_INFO_VAL" cols="30" ></TEXTAREA>
                        </TD>
                      </TR>

                      <TR>
                        <TD colspan="3" valign="top" align="left" width="150" height="7"></TD>
                      </TR>
                      <TR>
                        <TD colspan="3" valign="top" bgcolor="#808080" align="left" width="150" height="7"></TD>
                      </TR>
                      <TR>
                        <TD colspan="3" valign="top" align="left" width="150" height="7"></TD>
                      </TR>

                      <TR>
                        <TD colspan="3" valign="top" bgcolor="ffffcc">Delivery Address</TD>
                      </TR>



                      <TR id="ADD_SET_MED_TR">
                        <TD valign="top" bgcolor="#ffffcc" align="right">
                          <DIV id="ADD_SET_MED" style="font-weight:normal">
                            <NOBR>Additional Set Media</NOBR>
                          </DIV>
                        </TD>
                        <TD>&nbsp;&nbsp;&nbsp;</TD>
                        <TD valign="top">
                          <SELECT size="1" name="ADD_SET_MED_VAL" id="ADD_SET_MED_VAL" >
                            <OPTION value="--"></OPTION>
                            <OPTION value="Bond">Bond</OPTION>
                            <OPTION value="Vellum">Vellum</OPTION>
                            <OPTION value="Film">Film</OPTION>
                            <OPTION value="Transparent">Transparent</OPTION>
                            <OPTION value="Bond 110g">Bond 110g</OPTION>
                            <OPTION value="Trans 110g">Trans 110g</OPTION>
                            <OPTION value="Film 4.5mil">Film 4.5mil</OPTION>
                            <OPTION value="*Bond">*Bond</OPTION>
                            <OPTION value="*Bond 110g">*Bond 110g</OPTION>
                          </SELECT>
                        </TD>
                      </TR>


                      <TR id="ADD_SET_EDG_TR">
                        <TD valign="top" bgcolor="#ffffcc" align="right">
                          <DIV id="ADD_SET_EDG" style="font-weight:normal">
                            <NOBR>Additional Set Edging</NOBR>
                          </DIV>
                        </TD>
                        <TD>&nbsp;&nbsp;&nbsp;</TD>
                        <TD valign="top">
                          <SELECT size="1" name="ADD_SET_EDG_VAL" id="ADD_SET_EDG_VAL" >
                            <OPTION value="--"></OPTION>
                            <OPTION value="Loose">Loose</OPTION>
                            <OPTION value="Staple Only">Staple Only</OPTION>
                            <OPTION value="Paper Edge Bind">Paper Edge Bind</OPTION>
                            <OPTION value="Wood Edge Bind">Wood Edge Bind</OPTION>
                            <OPTION value="Drilled Edge Bind">Drilled Edge Bind</OPTION>
                          </SELECT>
                        </TD>
                      </TR>



                    </TABLE>
                  </TD>
                </TR>
              </TABLE>
            </TD>
          </TR>
        </TABLE>
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